Individual provider Active NPI

Riley Amorette Stephenson

  • Case Manager/Care Coordinator
  • Pryor, OK
National Provider Identifier
1992217426
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
109 N Fairland
Pryor, OK 74361-4203
Phone
(918) 825-1405
Fax
(918) 825-1406
NPI assigned
Oct 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

109 N Fairland
Pryor, OK 74361-4203

Mailing address

109 N Fairland
Pryor, OK 74361-4203
Phone (918) 825-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411000158 OK Practitioner - Clinical Social Worker 7315461365 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Apr 9, 2025 Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

109 N Fairland St
Pryor, OK 74361
Phone (918) 825-1406

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1992217426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405",
            "fax_number": "918-825-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405",
            "fax_number": "918-825-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "RILEY",
        "middle_name": "AMORETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

Verify at the official NPI Registry.